Teaching the art of noticing – a poem
I noticed that you started the conversation ... before she sat down...
The home of general practice and family medicine
Samples (poem)
Our patients leave the room yet now some of them left behind. To be taken elsewhere, a fraction of body now extracted from mind.
On not being paternalistic
...maybe thinking of ourselves as being maternalistic acknowledges existing authority, and allows us to aim for our patients to thrive, to be in control of their destinies, guided by caring, wise professionals.
The clinician’s narrative and the patient’s narrative are ontologically equivalent
According to Miranda Fricker, epistemic injustice occurs when an individual is wronged in their capacity as a knower. Yuya Yokota argues that argue that Gabriel's concept of “fields of sense” reveals this to be not just an ethical failing but an ontological
On a knife edge in Scotland – A view from the deep end
An outbreak of violence is spreading across Scotland - not linked to gangs or organised crime. This time, the offenders are children. To stop this surge, Scotland must urgently invest in mental health services, youth programs, and community resources...
A poem: Heart failure.
Using a narrative based approach can also enrich our own perspective and give us boldness to hold back from encasing patients in the tight algorithms that chronic disease management is often associated with. Becca Quinn offers a reframing poem.
Should we be bothered that we are losing a QOF indicator for people with SMI?
This focus on cardiovascular risk is understandable, but it is not clear why the requirement to maintain a register of people with SMI has been removed, other than possibly to free up financial resources.
ADHD – Overdiagnosis or Opportunity?
The inherent co-occurrence of multiple physical and mental health disorders associated with neurodivergence underscores the need for a broad, holistic clinical lens in assessment. This presents a crucial opportunity for primary care...
From Error to Ethics: Five essential lessons from teaching clinicians in trouble
This handy book is in two parts. The first part is the five essential lessons for teaching clinicians in ethical 'trouble' (each gets a chapter). The second part of the book is in essence, ‘An introduction to Osler.’ It is accessible, engaging
Fixation error: When thinking fast becomes a patient safety risk
Fixation error happens when a clinician locks onto a particular diagnosis or route of action. It can mean that we become so focussed on one problem we think we can solve, and fail to see the mounting evidence that we might be
Pain management in rehabilitation: A call for integrated, patient-centred approaches
Effective pain management is fundamental to rehabilitation. The body cannot heal while in constant distress. Rehabilitation and primary care teams must embrace the reality that pain is not just a symptom to be medicated...
Technology and values in general practice
The real question is not whether AI can make GPs more efficient, but whether it can uphold the artisanal values of general practice at a time when efficiency seems to be all that matters.
Prompt injection attacks: an inherent vulnerability of healthcare AI agents
Richard Armitage worries that a successful attack on an AI agent in general practice could expose entire practice databases of highly sensitive information.
Yonder: menstrual cups and IUD displacement, deprived area GP retention, endometriosis diagnosis, patient assertiveness
Alex Burrell looks at papers on menstrual cups and IUD displacement, deprived area GP retention, endometriosis diagnosis, and patient assertiveness.
The Fall of Icarus: Using art to teach medical students about planetary health
Using art can help students connect a patient's condition to the broader impacts of planetary health ... GPs should encourage students to examine this remarkable situation, even if others decide it is easier to look away.
Women GPs and the NHS Ten-Year Plan: Is now the time to thrive?
The manifesto details concrete actions for individuals, organisations and the government to help retain women doctors. This manifesto comes at an important time, as we await the NHS Ten Year Plan.
A 10-Year Health Plan that puts patients first: the RCGP’s vision
The Government has already set out three key shifts for the plan to turn into reality: from hospital to community, analogue to digital, and sickness to prevention. These are laudable, but we need to ensure that they're backed up with action and
Is it time to retire the digital rectal exam?
"The British Association of Urological Surgeons (BAUS) has called for the exam to be omitted from primary care’s assessment of prostate cancer. Asking, ‘Is it time to retire the DRE?’ allows for reconsideration of patient assessment with a view to improving patient
I knew her smile…
A knock on the door. First patient of the day. “Hello… come in,” I say. I didn’t recognise the name, But I knew her smile. A poem by Rahhiel Riasat
Devalued: The financial erosion of the GP role
GPs across the UK are facing a decline in income, with the impact felt across all contractual roles. This stagnation and decline in GP pay is exacerbating already-significant pressures and declining morale across the profession.
An Ode to my first practice … Let it not be an elegy to my profession
Here is a group of GPs who have given their all for their patients, and the reward has been disillusionment and financial decimation. This is not just a personal tragedy; it is a warning about the future of primary care in the
Ethical Erosion
As a profession, our inability—or perhaps reluctance—to step back and reflect on practices that may need to change has no doubt contributed to our ethical erosion. But we are capable of change and reform both individually and collectively...
Artificial intelligence scribes in general practice: Sacrificing the art of medicine for promised efficiency
AI scribes may become better over time; however, much of what is said in consultations is context-dependent, emotionally inflected, and shaped by subtle interpersonal cues. Mohammad S Razai is not yet convinced that AI scribes are the answer to the GP workload
Madness of Sense and the Sense of Madness
A reflection on the madness of sense and the sense of madness. Anuj Sean Chathley captures the demoralising and costly effects of healthcare funding cuts in poetry. "...these changes do not save. They spend — time, money, morale, and sense."
Artificial Intelligence… or not?
You might be thinking, why is this important anyway? Who cares whether it is a human doctor or a computer algorithm that is writing the article? Well, I suppose that is one of the defining questions of our time currently in the
A letter from Nova Scotia (An open letter to Wes Streeting and Stephen Kinnock)
"Please can you give us an idea of your plans, otherwise later on this year, you may be receiving another letter from us in Nova Scotia, written whilst watching frolicking dolphins from a jetty..." An open letter to Wes Streeting and Stephen
From 100-Hour weeks to work-life balance… How did we get here?”
There is a growing mismatch between the structured, protected world of training and the reality of modern general practice, where decisions must be swift, pressures are high, and ambiguity is the norm, argues Anuj Sean Chathley
Becoming and being a doctor: A developmental journey
Many people also find it hard to believe that much serious education for doctors concerns a universe of medicine beyond facts... John Launer reviews a new book that takes medical formation seriously in this broad sense.
Delete after reading
All advice under Emergency Health Regulations is in line with current evidence and best practice and is therefore in your best interests. Acting against your own best interests is ... therefore prohibited. A Hoban dystopia.
The Clock Ticks Differently Now
We competed not for praise, but for endurance. For the longest call. The bloodiest shift. The boldest procedure. A hundred hours a week? A badge of honour. In those halls, medicine was not a career. It was a covenant. Poem by Anuj
Accurx Scribe – mousetrap or messiah?
I had the pleasure of attending the Accurx Connects conference, where an announcement was made that Swedish automated scribe company Tandem had partnered up with Accurx to provide an integrated AI ambient scribe for GPs, compatible with electronic patient records systems...
Stay in your lane?
If the goal of medicine is the promotion of health and treatment of disability, illness, and disease (let’s think of this as our lane?), then things are going to get complicated.
The shame of patient complaints
For some reason, which of course you later regret, you check your work emails. There is an email ...with the subject title “Patient complaint.”
Providing support for primary care clinicians after the death of a patient by suicide
Carolyn Chew-Graham and Sohrab Panday discuss how we can better support each other in primary care in the aftermath of a patient's suicide.
Artificial general intelligence: a risk to human health and humanity as a whole
"While substantial attention has been paid to its promises, much less focus has been directed to the harms of AI on individual and population health. More concerningly, almost no regard has been paid by healthcare and public health professionals to the threats
Beyond the label: An autistic paramedic’s perspective on the Oliver McGowan Training
When we train clinicians merely to manage autistic patients rather than to understand and support them, we risk reinforcing stigma and inadvertently causing harm. As healthcare professionals, we have a responsibility to listen to, learn from, and advocate for autistic people.
HPV Vaccine: A life saving shot still out of reach for so many
Despite its proven effectiveness, access to the HPV vaccine remains limited, especially in low- and middle-income countries. Zeynep Sude Yeşildağ calls on global primary healthcare to do better!
Scientific and sacred knowledge: The journey of a dual-trained academic GP and faith leader
As both an academic GP and faith leader, I've found that bringing together different knowledge systems can significantly enhance patient care and community engagement. It may offer fresh perspectives for today's healthcare challenges.
Revealing the downsides: the harms of AI to human health
"This article will remind readers of the benefits of these technologies to health care and public health, before drawing attention to the harms of AI to human wellbeing."
A new GP feeling at sea
Alongside the elation and excitement of reaching Certificate of Completion of Training (CCT) however, is a feeling of being somewhat cast adrift. There is a distinct lack of celebration and more importantly perhaps, a distinct lack of support.
Drug consumption rooms: Addressing Multimorbidity and Substance Use in Glasgow’s Deep-End Communities
The recent introduction of the UK’s first Drug Consumption Room (DCR) in Glasgow is a pioneering harm reduction initiative, offering hope for improved healthcare outcomes for some of the city’s most vulnerable populations. Paul McNamara and Faiza Ahmad discuss the benefits.